title: Cumulative poor psychosocial and behavioral health among low-income women at 6 weeks postpartum.
abstract: BACKGROUND
  During the postpartum period, women may experience unfavorable psychosocial and behavioral health in multiple domains with adverse effects on parenting and maternal and infant health. Yet, little is known about the accumulation of poor health across the domains of depressive symptoms; body image; diet and physical activity; substance use including smoking and alcohol; and general self-care at 6 weeks postpartum, the usual end of maternity care.
  
  
  OBJECTIVE
  The aims of this study were to evaluate relationships among the domains comprising psychosocial and behavioral health and to examine the distribution and risk factors associated with cumulative poor psychosocial and behavioral health at 6 weeks postpartum.
  
  
  METHODS
  This study was a secondary analysis of cumulative poor health assessed by self-report scales for depressive symptoms, body image dissatisfaction, diet and exercise, substance use, and general self-care among 419 low-income White, African American, and Hispanic women at 6 weeks postpartum. Multivariable Poisson and logistic regression were used in key analyses.
  
  
  RESULTS
  The correlation among psychosocial and behavioral domains had a range of r = .50-.00. In this sample of women, 45% had two or more domains in which they had poor health. The model testing risk factors for cumulative poor health was significant (likelihood ratio chi-square = 39.26, df = 11, p < 0.05), with two significant factors: not exclusively breastfeeding (odds ratio [OR] = 1.459, 95% confidence interval [CI] [1.119, 1.901]) and Hispanic ethnicity (OR = 0.707, 95% CI [0.582, 0.858], psuedo-R = .029). Within individual domains, significant risk factors (body mass index, not exclusively breastfeeding, ethnicity, education level, and parity) varied by domain.
  
  
  CONCLUSIONS
  Many low-income women postpartum have poor psychosocial and behavioral health in multiple domains, which constitute areas for health promotion and early disease prevention.
authors.affiliation: School of Nursing, The University of Texas at Austin, Austin, TX 78701, USA. lwalker@mail.nur.utexas.edu
authors.forename: Lorraine O
authors.initials: LO
authors.lastname: Walker
authors.forename: Bobbie Sue
authors.initials: BS
authors.lastname: Sterling
authors.forename: Sarah
authors.initials: S
authors.lastname: Guy
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mahometa
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D001526:Behavioral Symptoms; D001828:Body Image; D019052:Depression, Postpartum / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology*; D015999:Multivariate Analysis; D016012:Poisson Distribution; D049590:Postpartum Period / Q000523:psychology*; D011203:Poverty; D011584:Psychology; D012307:Risk Factors; D012649:Self Concept; D057566:Self Report; D013997:Time Factors; D044465:White People / Q000523:psychology; D016387:Women's Health; D055815:Young Adult